The Medical Assistance Advisory Council (MAAC) held its quarterly meeting with substantive discussion on several key Medicaid initiatives.

Department of Human Services officials said the Centers for Medicare and Medicaid Services has no further questions on the fiscal year 2016 Medicaid managed care contract. However, CMS’ review of the capitation rates in the contract is continuing and an adjustment could occur. DHS will be posting the FY 2016 contract on its Web site in the near future.

Highlights from the meeting include:

• Behavioral health services – Medicaid Director Valerie Harr summarized the increased funding announced by Gov. Christie in his State of the State message related to substance abuse services. Also discussed was the finalization of reimbursement rates as services are transitioned from contractual rates to fee-for-service rates.
• Children’s system of care – Assistant Commissioner Elizabeth Manley reviewed the components of the system and updated the MAAC on the pilots occurring under the comprehensive Medicaid waiver (ID-DD/MI Pilot and the Autism Spectrum Disorder Pilot). She emphasized that there are still many beds available for substance use treatment services; occupancy stands at less than 80 percent. The Department of Children and Families is looking at possible expansion of outpatient substance use treatment services since youth are more amenable to these services than they are to inpatient treatment.
• Managed Long Term Services and Supports – Deputy Commissioner Lowell Arye updated statistics related to the MLTSS implementation: 55 percent of those who are coming into MLTSS are receiving home and community-based services at the outset. While there has been a slight uptick in the population in nursing facilities, there is still a downward trend as an overall percentage of the MLTSS population. The increase in the absolute number of people age 65 and older is contributing to the change in the nursing home population. There has been a steady increase in the utilization of behavioral health services by the MLTSS population. With respect to appeals and grievances, most are related to personal care assistance. In general, the overturn rate is fairly low for this category of appeals, and a relatively low number proceed to the fair hearing stage.
• Dual Integration – The Office of Managed Health Care stated that there are approximately 12,000 unduplicated beneficiaries enrolled in dual eligible special needs plans, a 48 percent increase compared to January 2015. There are three D-SNP plans available; more plans could be available by 2017.
• Comprehensive Waiver Renewal – DHS must submit a renewal application to CMS by June 30. To prepare, DHS is preparing a concept paper that will be available for public comment in February. The amended waiver would take effect July 1, 2017. Rutgers’ Center for State Health Policy continues to conduct the evaluation of the waiver; a draft interim evaluation report is due by July 1 and must be submitted to CMS with the waiver renewal application.
• NJ FamilyCare Update – Enrollment has decreased 2.5 percent since June as a result of beneficiaries not responding to redetermination notices. However, the overall net increase in enrollment since December 2013 is 434,248, or 34 percent.

The next MAAC meeting will be held April 20 at 10 a.m. and is open to the public. Agenda items will include a review of the waiver renewal concept paper and comments received, discussion of the credentialing system, an update on the transportation broker contract award and a presentation by the Medicaid ACOs.